Tom Benninger, M.D.: Healing the World, One Patient at a Time

Dr. Tom Benninger Interview

Don Frederico: Tom Benninger is a retired physician who lives in Louisville, Kentucky. On more than a dozen occasions, Tom, along with other doctors and service providers, traveled to third world countries where they worked to address the needs of people who had little access to healthcare. Motivated by a deep and abiding faith, Tom has participated in medical missions in the Dominican Republic, Afghanistan, and Nicaragua. After briefly discussing Tom's background, I asked him to describe those experiences and how his faith inspired him to serve. I'm sure you'll find his story as inspiring as I do.

Tom Benninger excerpt: The humbling thing is to do what you did day-to-day and got paid for it and providing it in a foreign country where they don't have access to it. There's a part of you that wishes you did that 24/7, that you could do that and make a difference.

Don Frederico: I’m Don Frederico, and this is Higher Callings.

This afternoon I'm with my old college friend, Dr. Tom Benninger. Tom, how are you today?

Tom Benninger: Oh, I'm doing well, Don. I appreciate the opportunity to talk to you.

Don Frederico: I enjoy talking to you every time we do. You're one of the handful of people from our college class that I've stayed in touch with over the years. And it's because you and I were such good friends back then, and I always enjoy our conversations.

Tom, we're going to talk about the work you've done that's outside of your medical practice. I know you're retired now. You retired what, about two years ago?

Tom Benninger: The end of 2018.

Don Frederico: Okay. And I know you had a medical practice. You're an OB GYN, but, you also have done amazing volunteer work overseas, and that's really going to be the focus of this interview, but why don't we start just by talking about your background. Where did you grow up? What was your childhood like?

Tom Benninger: I was born in central Illinois and my parents had four sons, no daughters.

And at the time I was born, my father was a high school teacher. And when I was about two, he became the superintendent of an orphanage in central Illinois. And, a few years after that, felt called to the ministry and went to seminary in his mid-thirties. That resulted in a move to southern Ohio, where he had two churches for several years.

And from southern Ohio, we moved to Toledo where I went to high school and subsequently ended up at the College of Wooster in Wooster, Ohio, where we met, and also where I met my wife. But after my freshman year, my parents moved near Louisville to New Albany, Indiana. And I've lived in this area ever since.

Don Frederico: Now, before you went to the College of Wooster, were you thinking about medicine as a career?

Tom Benninger: When I was 14, we were visiting my grandmother in rural Illinois. And, it's too long of a story to go into, but anyway, there was an accident and I was shot with a shotgun and ended up in the hospital for about a week. And it was really during that time, seeing how dedicated the doctors and nurses were, and just more of the inner workings of the medical system that's what probably planted the seed because until then I didn't have much of a career destination.

I had been interested in veterinary medicine. The unfortunate thing when I was in college, the odds of getting into veterinary school was one out of 10, medical schools, closer to one out of three or one out of four. So maybe I was playing the odds.

Don Frederico: You also, when you got to college, you met a woman named Marcia, who became your wife. You and I were in the same class. I know Marcia was the year behind us. She was just a young thing when you met her. But she also had a family with a medical background. Did that influence you?

Tom Benninger: The I guess not-so-coincidental thing with that, when I learned about her father being a physician, was that after we dated for a year or so, she was scheduled to go on a mission trip, actually a repeat mission trip, to the Dominican Republic with her family.

And she asked her father if I could take her place, knowing that I was pre-med. And it was a nice sacrificial thing for her to do. And it really opened my eyes tremendously to some aspects of medicine I had no idea about, including short-term mission work. And just seeing once again, the tremendous effort and dedication of the staff, both physicians and nurses and ancillary people, you can't help but get drawn to that as something very valuable and helpful.

Don Frederico: Maybe, before we talk about the trips that we're going to cover, tell us a little bit about the medical practice you had. How many years were you in practice?

Tom Benninger: 35.

Don Frederico: And all in Louisville?

Tom Benninger: Yes.

Don Frederico: And in your father-in-law's practice, at least starting out. Tell us a little bit about your experience there.

Tom Benninger: When I began working August 1st of 1985, within the first 10 days I had three sets of twins that I delivered, and I felt like my older partners set me up somehow. I don't know how they did it, but I happened to be on call for all three sets.

Don Frederico: You were twice as productive as them during that time period.

Tom Benninger: (Laughs) I'm like I needed a pay raise. But so it was hitting the ground running for sure. And our first child was born, Ethan, after we'd been married about five years. It was when I was in residency. And then we had a daughter and two other sons eventually. And it was very busy as you can imagine.

Being in residency is a trial by fire. There were occasions where you would be on call or working 36 straight hours, have 12 hours off, go right back to 36 hours. And you would do that for stretches to where you just didn't know which end was up. You could function and looking back, it's incredible that everybody did their jobs effectively and efficiently, because I guess it was adrenaline. I don't know how else to explain it.

But so getting into private practice was a dream, because there was so much less intensity and constant working, but the night call still wears on you. And it was in I think about 1998, I just felt a little bit overwhelmed and explored the possibility of stopping the obstetrics part and concentrating on gynecology.

And I thought about it for a couple of years and finally decided to do that. And it was a wonderful blessing. There was a dip in income initially, but over time, a lot of your patients who by then have transitioned to not needing obstetrical care anyway were happy to just have you be there for their annual checkups.

And then other older women would choose you because of that possibility. And so then that next half of my career was just gynecology with annual checkups and surgery. And I felt like I really could concentrate more on the surgery and really enjoyed keeping up and latching onto some of the newer things, like robotics and laparoscopic surgery, in a way that I would have been a little bit more intimidated by if I was still doing a lot of obstetrics.

Don Frederico: So Tom, let's transition now and talk about the work you've done overseas. And just to lay it out at the beginning, you have participated in a number of mission trips to different countries, particularly poor countries where you and other physicians who went with you performed surgeries and provided medical care to people in countries where they really didn't have access to medical care, other than through mission services, like the ones you participated in.

Is that a fair statement?

Tom Benninger: Yes, it is. I would say though, too, the opportunity of working alongside some of those who were permanent and lifetime missionaries was completely humbling. It made you feel like your short-term experience there was a drop in the bucket compared to their lifetime of service and work.

Just to put things in perspective and not that the short-term trips and what you could do weren't appreciated, but I would say I'm awed by those who have spent their lives doing that, raising their families in a foreign country and just giving total devotion to their work over there.

Don Frederico: I guess in my profession of law, there's an analogy that can be drawn between people who take a pro bono case once in a while and people who work for legal services organizations and are full-time providing that kind of service to people who can't afford lawyers. But I think your experiences were probably a little more intense than anything that most of us lawyers experience doing pro bono work.

So let's start. Your first trip was actually when we were in college, and I had forgotten that you had done that. In 1975, you went on a trip to the Dominican Republic which was a mission trip. Can you talk about that please?

Tom Benninger: It was through an organization that's still very active out of Bristol, Tennessee, called the Christian Medical and Dental Association.

And at the time they had a connection in a lot of places around the world, but one of them was in the Dominican Republic in a rural mountainous area that Marcia had been on a trip with her dad to the Dominican Republic, but in a different location a couple years prior. And she just told stories of pulling teeth. They just had a line of hundreds of people coming through and pulling teeth and putting it in a coffee can. And then the next patient. They did eyeglass testing and provision with eyeglasses on that trip. Ours was strictly surgical. And there was a mobile surgical van that CMDA had, but that they parked on the premises of the hospital. But we also used the operating room of the hospital. And that was eye opening, to say the least, because the windows were broken out in the operating room.

Don Frederico: What do you mean they were broken out? There was no glass in the windows?

Tom Benninger: No glass. And they would, any refuse from the kitchen or whatever just got dumped out windows onto the grounds. Literally there would be pigs that would run through the hallways occasionally that somebody would try and catch.

The hardest thing from our perspective was the lack of consistency of the electrical power. So we would have times during surgery, when the lights would go off and the flashlights would come out, and fortunately it was primitive enough, at least what was being done in the hospital, that you didn't need, largely local anesthesia and that sort of thing.

The mobile van had its own generator. So the big cases, gallbladders, hysterectomies, other things were done in the mobile van and the smaller things were in the hospital OR which wasn't quite as critical.

Don Frederico: Was all of your work in a hospital or was some of it outside of a hospital?

Tom Benninger: No, here we were stationed. We were living with some missionaries who were there full-time, Ed and Kathy Brainard. And actually with a couple of the other guys, I was in this, it was, I think, had been a bar, and we had a a shower which was an open water pipe coming out of the wall. And I don't remember too much of the other details. I probably blocked them, PTSD or something. But we, there were about 15 in the team and we had anesthesiologists, three surgeons and various assorted, other helpers and nurses and so forth. But it was bare bones. The disposable surgical gloves they would wash, re-sterilize, hang out on the clothesline after they were washed before they re-sterilized them, did everything they could to be efficient.,

I just remember the people being so sweet and so thankful to have medical care come to them because they had no opportunity to get to Santo Domingo, for the hospital care or anything like that. And that really has been the case in all the places I've been that these are areas that don't have access on a regular basis and people put up with things that, it just makes your heart ache, to think that they don't have an opportunity to get a hernia fixed or a surgery to get rid of a benign tumor that's so big they can hardly get around and that sort of thing. So it's a wonderful experience, but also so humbling and it's eye-opening to what a lot of the world, much of the world has to deal with on a regular basis.

Don Frederico: Now, how long were you there on that trip?

Tom Benninger: It was about two weeks. And the reason I remember is because the in-between weekend, we did go into town and we had pizza and most of us got “turista” from the pizza. So we were availing ourselves of the antidiarrheal medications for a few days.

Don Frederico: Lovely. You don't want the doctors to get sick. I mean, then where do you go?

And during those two weeks, what's your best guess? How many surgeries did you perform?

Tom Benninger: Let's see. With both the ORs going all day long, it probably did at least 10 cases a day, which is pretty amazing for efficiency for that small of a group. And because we would get to the hospital about 7:00 AM and usually not get back to the house most of the people were staying in for dinner till about 7:00 PM. So it was pretty much all day long.

Don Frederico: And this was all volunteer work you did through essentially a Christian medical mission.

Tom Benninger: Yeah. Yeah.

Don Frederico: You mentioned that Marcia had done it with her father a couple years earlier. And that's how you got involved. So you, this wasn't something you were going out of your way to try to find this kind of opportunity. It came to you.

Tom Benninger: Exactly. Yeah. That's the other humbling part. I can't claim to have started out with a goal for my life of doing mission trips. Each of the ones I went on I would call it “a God thing,” that there was a trigger or an opportunity that arose that I wasn't necessarily looking for when it came about.

Don Frederico: But you said yes when it came up.

And I know you told me something about a woman who you or someone else had operated on, who came back to thank you and let you know how she was doing.

Tom Benninger: She had, I think it was a hysterectomy early in the week, and most of the patients would go home the next day. They were just strong and determined. And so she went home probably after her Monday surgery and Friday, she walks five miles back just to tell everybody she was doing great. And then five miles back home.

Don Frederico: That's really fantastic. And those are the kinds of things you develop, right? These connections with people and people that you've helped. And I imagine that's just very rewarding when they come back to report back to you.

Tom Benninger: There was one other story I just happened to think of. I hadn't really thought about it in a while, but there was an elderly man that was getting a hernia repair and they were able to do it under local anesthesia, but it was a pretty humongous hernia. And he's just singing hymns during the procedure. He was singing, and one of our people said what is he singing? He said, oh, he's singing a Christian hymn.

Don Frederico: In Spanish, I imagine.

Tom Benninger: Yes.

Don Frederico: That's just great.

So that was the only time you went to the Dominican? Okay. And then a few years later you went to a place that's been very much in the news lately for kind of very sad reasons. But you went to Afghanistan in 2002. This was after the war had started. And after I think Americans had routed the Taliban, to whatever extent we routed them in 2001 and 2002. Can you talk a little bit about the circumstances before we get into more of the details about the work you did?

Tom Benninger: Sure. When I was doing both obstetrics and gynecology, there was a small group of us. So to take more than a week of vacation really was never an option because of the obstetric night call. And so when I stopped doing obstetrics, there was more of an opportunity of extended trips. And after 9/11, which I think shook all of us, and there was a suppression, anyway, of the Taliban, and I just had a sense of wishing there was something to be able to do for the people of Afghanistan and more than just donations and sending money. And in January of 2002 I ran into a good friend from medical school who was a pediatrician. And he was on the missions committee for a local church, Southeast Christian Church.

And I just said, "Oh, David, what are you doing?” He says, "Oh, actually getting ready to go to Afghanistan." And I said, "What??!!" And he said, he told me that there was a small group from the church. One of the members was an anesthesiologist who had been involved with Operation Mobility and getting wheelchairs into Afghanistan, even under the Taliban, if you can imagine.

So he had been there and after things calmed down, he had a vision of taking some physicians and nurses over there to establish a beachhead with one of the local hospitals in Kabul and see if there would be an opportunity for ongoing mission. So his name was Russ Summay and he was the leader of the group.

And I talked with Russ and there was enough time for me to consider going and I felt really called to do it. It's one of those things where you commit to it and then you think, what am I doing? What am I about to do?

Don Frederico: I didn't realize it was in January of 2002 that you had this encounter with this gentleman. And I remember so vividly, where we were at that time. It was still very fresh. It was only what about four or five months after the attacks, the 9/11 attacks, and Americans were still very much on edge. I know I was, wondering what was going to happen next. And so it had to be especially concerning to go at that time. Things hadn't really settled down yet, as I recall even though I don't know what the status was of the American invasion in Afghanistan, but maybe you could talk a little more about that. How much was the United States in control at that time? And how suppressed were the Taliban when you got over there?

Tom Benninger: When I talked with Russ about some of those issues, his contact in Kabul was a gentleman named Wakil, and he said, "I really feel confident in Wakil being able to assess the situations and let us know if there, if it's dangerous and if this is a timeframe that it might be advantageous to go.”

And as we did the preparations between January and March, things seemed a little calmer and a little more in control to the point where everyone who was going to be going on the trip felt comfortable. And we, it was amazing because, there was a man there from Loma Linda California, others from different areas around the country that we met in Chicago, before we flew the first leg of our journey.

And everybody had a similar urge to participate without knowing exactly what to expect. One of the men was Ian Crozier, who was doing a fellowship in infectious disease at that time, was one of the Americans who got Ebola early on and fortunately survived, but he was the unnamed doctor for months.

And then after the fact, I knew Ian had it because of our contacts. But fortunately, he got through it now. I think he still had some after-effects, a year or two later, but Ian was on the trip. We had a priest, we had a plumber, we had a pastor, pediatrician, anesthesiology. It was a hodgepodge of people, and everyone ended up being able to contribute in remarkable ways on the trip.

So my story wasn't unique, I don't think. And actually, we might get into it a little later, but the plumber was the most effective person out of our group, I think.

Don Frederico: How so?

Tom Benninger: We could not fly into Kabul. We had to fly into Peshawar, Pakistan, and as we were there awaiting the departure the next day there was a group of engineers from EMI engineers, Engineering Missions International, and they were coming out of Kabul as we were getting ready to go in. So that night at dinner, the engineers, we were just talking and at the dinner, spread out on the floor, they said, "Boy, it'd sure be great if you guys had a plumber, that's what they really need," because the septic tanks in the hospital were full.

And one thing led to another and our plumber who was retired military, got access through the embassy to military pumping trucks and bought PVC pipe, and two truckloads of sewage was taken out of the septic tanks so they could use them because they were dumping bed pans out the windows on the hospital grounds at that point. So it was just another real God thing that we just shook our heads in amazement at.

Don Frederico: And this was just a group that kind of loosely assembled originating in a church in Louisville.

Tom Benninger: Right. People had heard through the grapevine about the mission trip. And I don't even remember everybody's individual story, but it was a phenomenal group of individuals and obviously willing to experience a little bit of adventure, not for the sake of being an adrenaline junkie. It was because they felt a calling to go and do something to be helpful.

Don Frederico: So Tom, when you got there what did you see? What were the conditions when you arrived in Afghanistan, you were in Kabul, or just outside?

Tom Benninger: We were there, we were just real close to the American embassy, which we didn't know if that was a good thing or a bad thing as far as being protected or being a target.

But when we left Pakistan, we had to go overland through the Khyber Pass, and so that was an 11-hour van ride. They told the women to restrict their fluids because there'd be no place for them.

Don Frederico: How many women were on this trip with you?

Tom Benninger: We had four, I think, in our group, nurses.

Don Frederico: That had to be especially dangerous for them. If you encountered any Taliban, anyway.

Tom Benninger: The way between Pakistan and Kabul at that point had been, seemed relatively safe. There, the road was bombed out in places and we'd have to go out through the desert and detour, and other than the condition of the roads themselves we did not encounter any hostility.

One of the amazing things, we get into Afghanistan and hundreds of acres of opium, poppies growing just wild. And that's where the Taliban got a lot of their money was on the opium trade. So we, we did the van trip. We arrived at the guest house and it was crowded. But they did everything they could. We had good food. And we just hit the ground running, establishing contacts with the medical staff at the local hospital. During our trip there, because of cross connections of some of the NGOs, we ended up helping with a food distribution, a rural clinic, taking supplies to the hospital, some of the doctors did some teaching at the hospital.

The most important part of our trip probably was establishing those human connections with the hospital staff, many of whom had never had contact with Americans before. There was a military presence almost everywhere. We would hear gunfire during the night sometimes, but day by day Wakil knew where the safe places in town were and where they weren't or which routes to take through town. And he told us up front, he said, "There are Taliban we will be in contact with daily, who shaved off their beards and melted into the woodwork, but they know they're being watched and they will not cause any trouble."

And so we had a relatively incident free trip. I think there were maybe a couple minor accidents, and traffic, which, if you saw the traffic, you would wonder why there weren't horrendous major crashes constantly because no one paid attention to the traffic laws. But it was not anything worrisome from that aspect. When we would hear news from home, we worried more about what was going on in the United States than we did downtown Kabul.

Don Frederico: How long were you in Afghanistan, Tom?

Tom Benninger: About two weeks. Yeah, it was about a two week trip.

Don Frederico: How did your family feel about you going?

Tom Benninger: It was hardest on my parents, as you can imagine to not have any control over this. Although they were philosophical about it, especially they had to admit, they raised me the way they raised me. And at that point, your children's decisions are their own. And if you're doing things, hopefully for the right reasons, then they know the Lord will protect you. But Marcia never expressed any fears or concerns, but I have to think that they were there just because of where we were going and the lack of contact during that length of time.

Don Frederico: What work did you personally do while you were over there?

Tom Benninger: Probably the most hands-on were the medical clinics, and it was not a medical clinic in the sense that you were able to make a diagnosis and set someone up for surgery and that sort of thing. It was largely listening to complaints about aches and pains.

We did have some antibiotics. We did have some over-the-counter pain medicines. Did blood pressure checks. If we had prescriptions of antihypertensives or something like that the hospital was making the best effort to fill those prescriptions. But, it was hard because we were around physicians who were not being paid at the time.

They were giving their services up to help their people. And the teaching hospital we were in was called “Maiwand.” And it was, I am sure there were better equipped hospitals in Kabul, but this one wasn't. They did plastic surgery, ear, nose, and throat, orthopedic surgery and general medicine.

And they did tell us under the Taliban, women were not allowed to be admitted to the hospital. I guess they got whatever little care they could and in private women's clinics or something like that. That kind of restrictive mentality is just hard for Westerners to even fathom, that things like that were still going on in our modern world.

Don Frederico: And what were the people like that you encountered?

Tom Benninger: Wonderful. Wakil was an example, I think, of all the Afghans. Always had a smile on his face. He spoke wonderful English.

One of my favorite memories of Wakil, we were going on this trip, this 11-hour trip through the Khyber Pass. And at one point we stopped at a little roadside place for juice boxes and fruit, and he comes back to the back of the van and he said, "are you fresh?" And we all just laughed. And he meant refreshed after our stop. We said, "Yeah, we're as fresh as we can be under the circumstances." But he was unfailingly kind and optimistic. Helpful. He coordinated everything that we did with the local staff.

And the people, they had this thing. One of my contacts was one of the ear, nose and throat people. And he bonded to me for some reason, and he would grab and hold my hand. And, of course, the other men in the group were taking pictures and ribbing me at the end of the day. “Oh, how was the handholding today?" But that's just their expression of affection and kindness.

And one of the times we were at the hospital, we're having a meeting with everyone and they had some milk concoction that they really wanted me to drink. And I, it was room temperature milk that I'm sure had not been pasteurized.

Don Frederico: What kind of animal did it come from?

Tom Benninger: (Laughs) I do not know. So anyway, they were encouraging me to the point that I tried it, and I did not get sick. So that was a victory.

Don Frederico: So overall, Tom, what did you come away with from that trip? What thoughts? What impressions? What was the takeaway for you?

Tom Benninger: Yeah, I think the number one thing, Don, that I felt was how everyone around the world is the same. We all have basic needs and basic interests, basic talents and abilities that governments get in the way of, that political processes and political systems cover over. That the basic things that I've seen in my limited travels with every group of people, the same thing in Central America, that you can bond almost instantly with people with a smile and a handshake or a hug, and providing something for them that they couldn't have gotten otherwise. And I think the humbling thing is to do what you did day-to-day and got paid for it and providing it in a foreign country where they don't have access to it.

There's a part of you that wishes you did that 24/7, that you could do that and make a difference. And I can certainly see why lifelong missionaries get that. First of all, they have the commitment upfront or it wouldn’t work, but they have that experience and that opportunity on a daily basis to know they're making a difference in these lives.

Don Frederico: You went back to Afghanistan two years later. Tell us about that trip.

Tom Benninger: It was partly because Russ was going back, Russ Summay, and because of my respect and admiration for him. They'd asked if I would participate again and they wanted to do something that was a little more concrete. And they had a project of getting a used ultrasound machine over there for the hospital.

It was amusing on our first trip that the hospital director, when we were talking with him, we said, "Is there anything else we could help with?" And he said, "Oh, we could really use a CT or an MRI scanner." And we had to just gently help him understand the logistics of, number one, the fact that they don't have consistent power, that you need a whole staff to run the machine, to be trained for it, to keep it maintained and to repair it. But we thought an ultrasound machine for the hospital for scanning pregnant women and gynecologic exams would be helpful. So that was one of the focuses of the trip in May of 2004.

And one of our nurse practitioners in our office also went to Southeast Christian Church. And when I asked her if she would be interested in going, did express an interest and ultimately went. And I know it was very hard on her family. She had two teenage daughters and her husband wasn't as much on board with her going. But things had calmed down even more since 2002. And we'd had a two year almost continuous stream of people going back and forth from the church and with other organizations. The logistics were ironed out even more. Plus, at that point, we could fly directly to Kabul, to the airport there on Ariana Airlines instead of having to go through Pakistan. So it was more of an efficient trip and that sort of thing.

So the focus of that was not just the ultrasound machine, but there was a dental clinic in a little town called Istalif that was on the edge of Kabul that we had some equipment to get up to the clinic so that would be able to be up and running. Let's see, there were really more in-depth contacts with the hospital and other things through the ministry of public health in Afghanistan, important logistical and streamlining things that we had meetings in order to be able to do.

And so it was a smaller group and a little different focus, but it was still one of those situations where day-to-day, it was more Wakil knowing what and where and how to do things for that day, that we were able to do it. So that's the thing. It's critical to have boots on the ground, people like that who are there all the time that can direct your group and your mission, your purposes. So he was excellent in doing that.

Don Frederico: Were you there for two weeks that time?

Tom Benninger: Yeah, that was another two-week trip.

Don Frederico: These trips cost money. Where did the money come from to take this trip?

Tom Benninger: Some of the people would have donors who either spontaneously or on request would help fund the trips. I fortunately was able to do some of it myself. My first trip to Afghanistan, my father-in-law really wanted to pay for my expenses. And so he took care of all that. But those were good stories too, because some of the trip members would meet with friends and family and discuss the prospect of them going. And were able to share not only the opportunity for them to support them in their trip, but also to become a little more invested personally in something of this magnitude. And time and again, we heard of people who would say, I can't personally make the trip, although I would like to, but I certainly would like to help in helping pay someone's way. So it was a variety of different sources that people were able to get help in order to be able to go on the trips

Don Frederico: All of that, through your trip to the Dominican, your two trips to Afghanistan are really almost a prelude to what you did after that. And I'm talking about the many trips you've taken to Nicaragua, another Spanish speaking country where you, as I understand it, also provided medical services and surgery, conducted many surgeries.

Tell us about how you got started going to Nicaragua, when you got started, and what you were doing when you were there.

Tom Benninger: Let me just give one postscript to the Afghanistan trip because with both trips, there was hope of my being able to utilize my own specialty in some ways, both either in teaching or in some clinic work with obstetrics and gynecology, the reality was even at that point, for a male gynecologist in Afghanistan, there were many limitations. And so that was frustrating to a certain degree, even though I feel like there were still some humanitarian goals that we were able to reach.

So then what transpired, as far as my interest in opportunity in Nicaragua, was a really good friend, actually a former neighbor in Louisville who had moved to Atlanta, had been on two trips to Nicaragua through his church for short-term missions.

And I think just through a phone call, we were catching up and he was telling me about having, on the second trip, been able to facilitate a gynecologic surgery group, and he and another physician were able to do a small number of surgeries in a mission hospital there in Chinandega, Nicaragua, which is about 120 miles north of Managua.

And he didn't recruit me in the sense of saying, "I really hope you could come," but as I asked more questions about it, I think he simply said "We'd be happy to have you on the next trip." So it took a little bit of consideration, but not much because I really respect and admire this particular physician. He was two years ahead of me in training.

But I went on that trip, and my daughter who was in college at the time majored in Spanish. So she went along as an interpreter and, indirectly, subsequently ended up being a physician assistant because of that experience. She had a couple of other jobs after college. And even though she said she would never take science courses for college, she got her prerequisites, went back and got her physician assistant degree, and has been working at that currently in Ann Arbor, Michigan at the University of Michigan. But that's just a sidelight from that first trip.

But we had our own staff of two operating gynecologists, one anesthesiologist and nurse anesthetist and several nurses. And at the little mission hospital, we had our own set up for operating recovery. And it was just down the street from the mission house that we were staying in. Leaky roof and cold showers and all. One of the men on the trip said "One thing about cold showers, the mirrors don't fog up." So I guess you can always look on the bright side to everything.

Don Frederico: There's a bright side to everything. There's a silver lining.

Tom Benninger: Yeah. Lance Wiist is the physician that I was with who spearheaded the trip. And I did, I think probably 35 or 40 cases that, that week that we were there.

Don Frederico: When you say cases, you mean surgeries?

Tom Benninger: Mostly major surgeries. Yeah. And it was under conditions that were different than we were used to doing in the United States. But the one thing good was the inner-city hospital that we were trained in was a little bit like a MASH experience to some degree.

We had 40-bed un-airconditioned wards. We had a little bit more primitive operating rooms and so forth. But so we didn't have our laparoscopic equipment and some of the other things that we normally used, but we knew how to do hands-on, old-fashioned abdominal surgery and other vaginal surgery cases too. And so it went really well. Again, it was a variety of different cases.

One of the sweetest experiences when one of the patients in a recovery room, a little old lady, all smiles a day after surgery. And she said, "This has been like staying in a beautiful hotel." And we all just looked at each other and grinned. And we said, "Have you ever stayed in a hotel?" "No, but I saw one once on TV." We just all broke out laughing.

But the hardest thing was the first day there, we would always do a clinic and we'd see usually about a hundred patients and once the surgery schedule filled up, we could not add any more patients in, even though there were still people that were waiting or hoping to be able to get in for surgery.

And we would take their names and they would be first on the list for the following year. But that was a hard thing, just knowing there was a limit to the capacity. But you still had the feeling of at least you made a difference in the lives of the people that you were able to help.

Don Frederico: And these were people who had no access to healthcare generally?

Tom Benninger: Yes, they were folks in the rural community. They would have then triaged to be able to come either through a radio public service announcement. The Amigos for Christ organization that we were working with had rural clinics and they would, their doctors or their staff would screen patients to be able to come in for the surgery. So it was a variety of different ways that people became aware of the services being offered.

Don Frederico: And that organization, Amigos for Christ, they're there full-time?.

Tom Benninger: That's a beautiful story too. I would encourage anyone who would like to get more information to go to their website, Amigos for Christ, I think it's dot org. They're out of Buford, Georgia, but the family that started Amigos, John and Sabrina Bland, went down after Hurricane Mitch to help out with a group from their church.

Don Frederico: When was that? When was Hurricane Mitch?

Tom Benninger: Okay. I'm thinking it was ‘98. I'm a little fuzzy, but it was about that timeframe, I think 1998.

And were so overwhelmed by the need. He sold his company and he and his wife began living there full time. They had a stint in the Peace Corps way back when, so they were not, this was not an unknown thing to them, but to really give up everything to do that. And the organization has just grown gradually.

Their staff is over a hundred now, mostly staff that provides their own support. Their main thing is community building with homes, community centers, schools, all those sorts of things to help a small group of people. And each group helps the other group get started building the homes. Their main thrusts are education, nutrition, hygiene, all those kinds of things. Things where you just take for granted. Clean water, access to nutritional information, and so forth.

In fact, one of the disheartening things was when they began building these small cinder-block, three-room homes, people kept building fires inside their homes and the carbon monoxide levels inside, they tested them and they were more than a year's exposure in one day that we would find healthy. They kept saying "You can't cook in the home, cook outside." And I think they finally made some inroads in that, but they, it's just tremendous, providing animals for food and taking pregnant animals and sharing the offspring with others, micro loans, micro businesses, helping them start.

It's just phenomenal. And we were talking the other day and one of the neat things is they don't over-commit. They will wait until they have the resources to fund a project before going forward. So their overhead is tremendously low. Their efficiency rate is tremendously high.

Don Frederico: And you've been there not once, but ten times. Is that right?

Tom Benninger: Ten times. We've been in three different hospital settings. The mission hospital was the first couple years. Then John Bland had a vision to interact more with the community. And we went with the local community hospital, which was from our perspective a disaster in the making. But it did work and we did have opportunity to interact with the hospital staff, more family members through that.

 It's just been a real blessing. And at the outset, there was a lot of pessimism. And after that first year, it was just miraculous to see how well things meshed together. Then that hospital we were at for two years until an earthquake damaged it so severely it had to be razed to the ground.

So then another community hospital allowed us to come in, and that's been the location for the last several trips.

Don Frederico: How are Americans received in Nicaragua?

Tom Benninger: Extremely well. They have pretty stringent criteria for us coming in. All of our licenses and diplomas have to be up to date. They're very particular about the medications we bring in. If they're within just a few months of expiration, they won't allow them to come in.

But really on the whole, they're very happy to see us. There are minimal hindrances. We all know the circumstances in Nicaragua and the unrest a couple of years ago with protests for the government that were violently put down. It actually curtailed a trip or two for us to go.

But I think because they appreciate outside groups coming in and having the Amigos for Christ there all the time, there's that beachhead with the community constantly. And we would several times have gotten certificates of commendation from the ministry of health for being there and helping out. And they have one of their administrative assistants come and hand out the certificates. And it's real time there at the end of the week.

Don Frederico: So Tom, you've been going there since 2009. You've made ten trips. How many more trips do you have in you?

Tom Benninger: That's a good question.

We actually were scheduled to go this past February and so our next trip is tentatively for upcoming February, but the problem is the uncertainty of the situation in Nicaragua, as far as the pandemic. There's not a reliable way for people to be tested or to be vaccinated. And with the variants, I don't know exactly. I'm hedging because I don't know what the answer to your question, but I'm hopeful that there's at least one more trip. I'd like to get back there at least one more time.

Don Frederico: Has Marcia gone there with you at all?

Tom Benninger: She did. She went one time. And she is a registered nurse. And as Don knows, she's the sweetest woman that I know. And I'm not prejudiced at all in saying that. So she was received with open arms and she was willing to do anything that she could do.

And just being there with her was a wonderful experience for me. And we have a disabled son which limits her being able to go more than she has. But that was, just that one time was a wonderful and fun experience for me.

Don Frederico: Tom, listening to your stories, the phrase that comes to mind is, and thinking about both you and Marcia and of course influenced by the fact that I've known you both for many years, is "salt of the earth." You're just the salt of the earth. And I don't mean only you. I know the other people that go on these trips are also doing wonderful work and they're doing it out of a deep and abiding love of people, and in many cases, faith. Do you want to say anything about how your faith motivates you to go so far out of your way and sacrifice so much of your time and energy to help people in need of help?

Tom Benninger: I think that the little bit that I could say in regards to that is the desire to have a practical outworking of your faith. I think that little book of James in the Bible is so helpful because he says at one point, what good does it do to tell someone to be warm and filled if you don't assist them in achieving that? And Paul talked about, there are works that have been prepared beforehand for you to walk in. And I think that would be the motivating factor, knowing that, if the faith doesn't have a practical outworking, you have to wonder a little bit the depth of it or the reality of it.

And I would not ever pat myself on the back because I feel that those who have been given so much, and for me, it's the gift of eternal life through Jesus’ death and resurrection, once you have a feeling of indebtedness and gratitude, then there's a natural outworking of wanting to be an ambassador, so to speak, for your faith.

And that's what I would have to say. And I think that, as I said in the beginning, my admiration is for the full-time missionaries who have given everything to doing this. And yet to hear them speak of their gratitude for those who come short term and help fill in the gaps a little bit and give them a break.

I know there are physicians in this country who will go over to foreign countries and work for a month or two so the full-time missionaries can have a little bit of a sabbatical. My hats are off to them too. Cause it's a logistical issue when you're trying to maintain your own work and medical practice to give up a fair amount.

Don Frederico: I find it really inspiring what you and these other folks do. And I know people of other faiths who also share the same sort of commitment to giving back to the world and serving humanity.

When you mentioned the book of James, the phrase that comes to mind for me is: "Faith without works is dead." And that's really what you're saying, and what you and other people who do this kind of work are exemplifying. They're not just talking the talk, they're walking the walk, as some people would say.

Tom, this has been wonderful. Do you have any last thoughts you'd like to convey before we end the conversation?

Tom Benninger: No, I think you did a great job, Don, just covering the waterfront. It's been a fun exercise to go back and look at diaries and dredge up some of these wonderful memories from the past. And I think I would just encourage people to keep the country of Afghanistan in their prayers.

Wakil does have an organization that is still helping Afghans in Kabul and also refugees. And it's EPEK, epekinternational.org. So if you have an opportunity, check that out. I know that all their hearts are in the right place and it would be a reliable opportunity to assist a little bit during this time of crisis, because yeah, I just, I hate to think of what some of those sweet people are going through again, and I, I don't know that there's an answer long-term. So many countries have, quote, invaded Afghanistan and lived to regret it. And the embarrassment to the United States of having to pull out, having only temporarily staved off some of these atrocities. I hope some way or another the pendulum swings back to a midpoint where there's some stability and some rational thinking and that the innocent people aren't the ones to suffer once again.

Don Frederico: Thank you very much, Tom. This has been really inspiring and I'm looking forward to sharing this conversation with other people. And hopefully you can share it with other people, too, when it's available. So thank you. And I also hope that sometime before too long we'll be able to get back together. We haven't seen each other in a few years other than through the computer and it would be great to do that.

Tom Benninger: I agree, Don. It's wonderful to get together however we can.

Don Frederico: Thank you, Tom.

Tom Benninger: Okay. Bye-bye.

Don Frederico: Bye-bye.